NPI | 1629961230 |
---|---|
Entity Type | Organization |
Authorized Contact | KRISTEN DEVILLE Lpc 318-715-7170 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
Enumeration Date | 2025-06-02 |
Last Update Date | 2025-06-02 |